Relationship of non-suicidal self-injury and suicide attempt: a psychopathological perspective

Abstract

Non-suicidal self-injury (NSSI) is not uncommon in the general
\npopulation, and is prevalent in association with a range of
\npsychiatric disorders including major affective, personality and
\nneuropsychiatric disorders. It often starts in childhood or early
\nadolescence and involves repeated bouts of self-injurious acts,
\nwith similar risks among females and males. Such behaviours
\nare distinguished from suicide attempts by an evident lack of
\nlethal intent. Nevertheless, NSSI and suicidal behaviours occur
\nfrequently in the same persons, and NSSI can be a precursor of
\nsuicidal behaviour. NSSI typically seems to represent an effort
\nto reduce overwhelming negative emotions, which can include
\ndysphoric or depressive states. Indeed, the experience of immediate
\nrelief may contribute to the repetition of self-injurious behaviours.
\nNSSI may also arise in response to a felt need for punishment
\nor a desire to influence or seek help from others. NSSI
\nbehaviours occur far more frequently than suicide attempts, and
\nusually are of low medical severity and rarely fatal. In addition
\nto representing an important psychiatric syndrome in its own
\nright, NSSI is a major risk factor for suicide that requires ongoing
\nassessment of suicidal intent.